Just Doing What You're Told

Part of my training as a nurse was to spend time on a mental health ward so in 1983 I was sent to what was genuinely a bin. One of the women there had arrived as a child when the building had been a Work House. There was an elderly man with Alzheimer's, a 16-year-old young woman with alcohol problems, several young people with learning difficulties and about 20 other people with diagnoses that I knew nothing about.

Young doctors practiced electro-convulsive ‘therapy’ on the elderly woman. Every couple of days the elderly man was dragged naked and shouting through the ward and made to stand in a bowl by his bed where water was poured endlessly over him as he became increasingly distraught. The 16 year old young woman was sedated every time she challenged the staff on the basis of what she was actually feeling, which was often. In retrospect she was being punished because the staff felt threatened by her obviously splendid intellect. One of the young women with a learning difficulty was offered voluntary work at London Zoo but the staff laughed at her, saying that the idea was as stupid as she was and they prevented her going. All the women were sexually assaulted by some staff and some patients.

Aged 18 and stuffed with the high moral ideals of my nursing school I imagined that this was an urgent problem. It was only because I was a gobby teenager who didn’t know better that anything got done: none of the managers and just one of the (very senior) teaching staff took me seriously. The school of nursing protected me and two members of staff were sacrificed. Nothing changed. I kept banging on about it until one of my teachers said, “What do you want? Blood?” I was flabbergasted that the alternative to dealing with grotesque abuse was perceived to be killing someone and at that point began to learn to shut up.

News that staff knew about Jimmy Savile’s abuse of patients shouldn’t come as a surprise. We know that people - often very senior, generously paid people - find it easier to punish less senior people than to take whistle-blowers seriously. We know that whistle-blowers are treated with absolute contempt and ill treatment, not just by managers but also sometimes by relatives of abusers.

DBS checks are a waste of time and a horrific waste of money. What actually protects vulnerable people is a culture, not of suspicion but of openness and transparency where every person from the most senior manager to the youngest student are expected to speak out about what they see. That culture is supported by a policy that has to be followed if someone alleges abuse: it's a statement on the poverty of where we are now, that a policy has to drive people towards transparency. 

I wasn’t the only student nurse on that ward but when I spoke to my peers about what we were seeing I was told that we were only there for 6 weeks, that it wasn’t that bad, that the staff knew what they were doing, that they didn’t want to risk a good review, that they were frightened. Just a kind of non-specific, generalised fear. As if the sky might fall on their head.

Every sphere of employment is full of bullies. Often, those bullies are out of their depth and anxious because they’ve been promoted on the basis of ticking some boxes in a selection process rather than because they are actually suited to their role. How many of us would admit that, turn down the big wage and move somewhere where we might be happier? But that’s their business. What is our business – your business too – is to ensure that we safeguard people who are weaker than we are. It’s not just in healthcare; it’s in offices where you have the power to make someone’s life worse.

Don’t.

The energy that you will have to use to protect yourself from knowing that you have made someone live without heating, without a home, without dignity will exhaust you. The people around you need to tell you that you’re doing the right thing because they’re doing it too. If this kind of behaviour makes you feel uncomfortable, take note. Leave if you can’t change the culture. If it makes you feel powerful, if you’re just following orders, you really do need support to stop.